REMOVAL OF BULKY TISSUE AT LAPAROSCOPIC SURGERY

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Abstract
A technique for extraction of bulky tissue during laparoscopic surgery is presented. One laparoscopic cannula is replaced with a sigmoidoscope which acts as a wide-bore cannula. At laparoscopic cholecystectomy, 22 of 60 (38%) patients were found to require wound enlargement to remove a grossly diseased gall-bladder. Use of a sigmoidoscope as a cannula was associated with fewer technical complications than surgical wound extension. At laparoscopic appendicectomy, the appendix could not be removed through the standard laparoscopic cannula in 16 of 46 (31%) cases. The incidence of wound infection was significantly lower after laparoscopic appendicectomy than among a group of 98 patients having conventional appendicectomy (P = 0.024). It is concluded that a sigmoidoscope can be used as a replacement cannula allowing uncomplicated removal of bulky tissue and reducing wound contamination.

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